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                  From Wikipedia, the free encyclopedia
                </div>
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                  >
                    Subspecialty of emergency medicine
                  </div>
                  <p>
                    <b>International emergency medicine</b> is a subspecialty of
                    <a
                      href="/wiki/Emergency_medicine"
                      title="Emergency medicine"
                      >emergency medicine</a
                    >
                    that focuses not only on the global practice of emergency
                    medicine but also on efforts to promote the growth of
                    emergency care as a branch of medicine throughout the world.
                    The term <i>international emergency medicine</i> generally
                    refers to the transfer of skills and knowledge—including
                    knowledge of ambulance operations and other aspects of
                    <a
                      href="/wiki/Prehospital_care"
                      class="mw-redirect"
                      title="Prehospital care"
                      >prehospital care</a
                    >—from developed emergency medical systems (EMSs) to those
                    systems which are less developed. However, this definition
                    has been criticized as oxymoronic, given the international
                    nature of medicine and the number of physicians working
                    internationally. From this point of view, international
                    emergency medicine is better described as the training
                    required for and the reality of practicing the specialty
                    outside of one's native country.
                  </p>
                  <p>
                    Emergency medicine has been a recognized medical specialty
                    in the United States and other developed countries for
                    nearly forty years, although these countries' EMSs did not
                    become fully mature until the early 1990s. At that point,
                    some of its practitioners turned their attention from
                    developing the specialty at home to developing it abroad,
                    leading to the birth of international emergency medicine.
                    They began to support the growth of emergency medicine
                    worldwide, doing so through conferences, national and
                    regional emergency medicine organizations, relief and
                    development organizations, international emergency medicine
                    fellowships, physician exchanges, information transfer, and
                    curriculum development.
                  </p>
                  <p>
                    Most developing countries are taking steps to develop
                    emergency medicine as a specialty, to develop accreditation
                    mechanisms, and to promote the development of emergency
                    medicine training programs. Their interest is a result of
                    improved healthcare, increasing urbanization, aging
                    populations, the rising number of traffic fatalities, and
                    heightened awareness of emergency medicine among their
                    citizens. In addition, emergency medicine is useful in
                    dealing with time-sensitive illnesses, as well as improving
                    public health through vaccinations, interventions, training,
                    and data collection. Countries that lack mature EMSs are
                    developing emergency medicine as a specialty so that they
                    will be able to set up training programs and encourage
                    medical students to pursue residencies in emergency
                    medicine.
                  </p>
                  <p>
                    Some challenges faced in international emergency medicine
                    include immature or non-existent training programs, a lack
                    of adequate emergency transport, a shortage of resources to
                    fund emergency medicine development, and an absence of
                    research that could inform developing countries how to best
                    spend the resources they devote to emergency medicine.
                    Additionally, the standards and methods used in countries
                    with mature EMSs are not always suited for use in developing
                    countries due to a lack of
                    <a href="/wiki/Infrastructure" title="Infrastructure"
                      >infrastructure</a
                    >, shortage of funds, or local
                    <a
                      href="/wiki/Demographics"
                      class="mw-redirect"
                      title="Demographics"
                      >demographics</a
                    >.
                    <a
                      href="/wiki/Ambulances"
                      class="mw-redirect"
                      title="Ambulances"
                      >Ambulances</a
                    >, the developed country standard, are costly and not
                    practical for the road conditions present in many countries;
                    instead, a variety of modes of transportation are used.
                    Furthermore, in place of expensive medication and equipment,
                    developing countries often opt for cheaper if slightly less
                    effective alternatives. Although it may seem that increasing
                    availability to emergency medicine must improve health,
                    there is little empirical evidence to directly support that
                    claim or to point out which methods are most effective in
                    improving patient health.
                    <a
                      href="/wiki/Evidence-based_medicine"
                      title="Evidence-based medicine"
                      >Evidence-based medicine</a
                    >
                    seeks to address this issue by rigorously studying the
                    effects of different interventions instead of relying on
                    logic or tradition.
                  </p>
                  <meta property="mw:PageProp/toc" />
                  <div class="mw-heading mw-heading2">
                    <h2 id="Background">Background</h2>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=1"
                        title="Edit section: Background"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
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                  <div class="mw-heading mw-heading3">
                    <h3 id="Definition">Definition</h3>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=2"
                        title="Edit section: Definition"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
                  </div>
                  <p>
                    The most commonly accepted definition of international
                    emergency medicine is that it is "the area of emergency
                    medicine concerned with the development of emergency
                    medicine in other countries."<sup
                      id="cite_ref-Arnold_1-0"
                      class="reference"
                      ><a href="#cite_note-Arnold-1"
                        ><span class="cite-bracket">[</span>1<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    In that definition, "other countries" refers to nations that
                    do not have a mature emergency care system (exemplified by
                    <a
                      href="/wiki/Board-certified"
                      class="mw-redirect"
                      title="Board-certified"
                      >board-certified</a
                    >
                    emergency physicians and academic emergency medicine, among
                    other things). Included in those nations are some that are
                    otherwise quite developed but lack a complete emergency
                    medical system, such as Armenia, China, Israel, Nicaragua,
                    and the Philippines.<sup
                      id="cite_ref-Arnold_1-1"
                      class="reference"
                      ><a href="#cite_note-Arnold-1"
                        ><span class="cite-bracket">[</span>1<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    Work in international emergency medicine can be broken down
                    into two main categories: 1) the promotion of emergency
                    medicine as a recognized and established specialty in other
                    countries, and 2) the provision of
                    <a
                      href="/wiki/Humanitarian_assistance"
                      title="Humanitarian assistance"
                      >humanitarian assistance</a
                    >.<sup id="cite_ref-Sistenich_2-0" class="reference"
                      ><a href="#cite_note-Sistenich-2"
                        ><span class="cite-bracket">[</span>2<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <p>
                    William Burdick, Mark Hauswald, and Kenneth Iserson have
                    criticized the above definition as oxymoronic, given the
                    international nature of medicine and the number of
                    physicians working internationally. From that point of view,
                    international emergency medicine is not solely about
                    development of emergency medical systems but is instead
                    better described as the training required for and the
                    reality of practicing the specialty outside of one's native
                    country.<sup id="cite_ref-Burdick_3-0" class="reference"
                      ><a href="#cite_note-Burdick-3"
                        ><span class="cite-bracket">[</span>3<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <div class="mw-heading mw-heading3">
                    <h3 id="History">History</h3>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=3"
                        title="Edit section: History"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
                  </div>
                  <div class="mw-heading mw-heading4">
                    <h4 id="Emergency_medicine">Emergency medicine</h4>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=4"
                        title="Edit section: Emergency medicine"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
                  </div>
                  <style data-mw-deduplicate="TemplateStyles:r1236090951">
                    .mw-parser-output .hatnote {
                      font-style: italic;
                    }
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                      padding-left: 1.6em;
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                  <div role="note" class="hatnote navigation-not-searchable">
                    Further information:
                    <a
                      href="/wiki/Emergency_medicine#History"
                      title="Emergency medicine"
                      >Emergency_medicine §&nbsp;History</a
                    >
                  </div>
                  <p>
                    Emergency medicine is a specialty that was first developed
                    in the United States in the 1960s.<sup
                      id="cite_ref-alagappan2005_4-0"
                      class="reference"
                      ><a href="#cite_note-alagappan2005-4"
                        ><span class="cite-bracket">[</span>4<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    For the United States, the high number of traffic and other
                    accident fatalities in the 1960s spurred a
                    <a href="/wiki/White_paper" title="White paper"
                      >white paper</a
                    >
                    from the
                    <a
                      href="/wiki/National_Academy_of_Sciences"
                      title="National Academy of Sciences"
                      >National Academy of Sciences</a
                    >; it exposed the inadequacy of the current emergency
                    medical system and led to the establishment of modern
                    <a
                      href="/wiki/Emergency_medical_services"
                      title="Emergency medical services"
                      >emergency medical services</a
                    >.<sup id="cite_ref-Pozner_5-0" class="reference"
                      ><a href="#cite_note-Pozner-5"
                        ><span class="cite-bracket">[</span>5<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    The United Kingdom, Australia, Canada, Hong Kong, and
                    Singapore followed shortly thereafter, developing their
                    respective emergency medicine systems in the 1970s and
                    1980s.<sup id="cite_ref-alagappan2005_4-1" class="reference"
                      ><a href="#cite_note-alagappan2005-4"
                        ><span class="cite-bracket">[</span>4<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <div class="mw-heading mw-heading4">
                    <h4 id="Beginning_of_the_subspecialty">
                      Beginning of the subspecialty
                    </h4>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=5"
                        title="Edit section: Beginning of the subspecialty"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
                  </div>
                  <figure class="mw-default-size" typeof="mw:File/Thumb">
                    <a
                      href="/wiki/File:Loma_Linda_University_Dennis_and_Carol_Troesh_Medical_Campus.jpg"
                      class="mw-file-description"
                      ><img
                        src="//upload.wikimedia.org/wikipedia/commons/thumb/2/2b/Loma_Linda_University_Dennis_and_Carol_Troesh_Medical_Campus.jpg/250px-Loma_Linda_University_Dennis_and_Carol_Troesh_Medical_Campus.jpg"
                        decoding="async"
                        width="250"
                        height="188"
                        class="mw-file-element"
                        srcset="
                          //upload.wikimedia.org/wikipedia/commons/thumb/2/2b/Loma_Linda_University_Dennis_and_Carol_Troesh_Medical_Campus.jpg/500px-Loma_Linda_University_Dennis_and_Carol_Troesh_Medical_Campus.jpg 1.5x
                        "
                        data-file-width="2844"
                        data-file-height="2133"
                    /></a>
                    <figcaption>
                      In 1994,
                      <a
                        href="/wiki/Loma_Linda_University_Medical_Center"
                        title="Loma Linda University Medical Center"
                        >Loma Linda University Medical Center</a
                      >
                      established the first international emergency medicine
                      fellowship in the world.<sup
                        id="cite_ref-alagappan2005_4-2"
                        class="reference"
                        ><a href="#cite_note-alagappan2005-4"
                          ><span class="cite-bracket">[</span>4<span
                            class="cite-bracket"
                            >]</span
                          ></a
                        ></sup
                      >
                    </figcaption>
                  </figure>
                  <p>
                    By the early 1990s, the emergency medicine systems (EMSs) in
                    the United States, the United Kingdom, Australia, Canada,
                    Hong Kong, and Singapore were largely mature, leading some
                    practitioners to focus on developing the specialty in other
                    countries.<sup
                      id="cite_ref-alagappan2005_4-3"
                      class="reference"
                      ><a href="#cite_note-alagappan2005-4"
                        ><span class="cite-bracket">[</span>4<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    Thus, international emergency medicine as a subspecialty
                    began in the 1990s, although some isolated efforts to
                    achieve some of its goals had taken place in the late
                    1980s.<sup id="cite_ref-alagappan2005_4-4" class="reference"
                      ><a href="#cite_note-alagappan2005-4"
                        ><span class="cite-bracket">[</span>4<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    There were several reasons for the heightened interest these
                    practitioners had in developing emergency medicine abroad.
                    One was the contrast between the EMSs of their countries and
                    the EMSs of other countries.<sup
                      id="cite_ref-alagappan2005_4-5"
                      class="reference"
                      ><a href="#cite_note-alagappan2005-4"
                        ><span class="cite-bracket">[</span>4<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    Another was the
                    <a
                      href="/wiki/Revolutions_of_1989"
                      title="Revolutions of 1989"
                      >revolutions of 1989</a
                    >, overthrowing authoritarian regimes, which facilitated
                    spread of new ideas, such as emergency medicine.<sup
                      id="cite_ref-alagappan2005_4-6"
                      class="reference"
                      ><a href="#cite_note-alagappan2005-4"
                        ><span class="cite-bracket">[</span>4<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <p>
                    Two international emergency medicine conferences were
                    launched in the 1980s, the
                    <a
                      href="/wiki/International_Conference_on_Emergency_Medicine"
                      title="International Conference on Emergency Medicine"
                      >International Conference on Emergency Medicine</a
                    >
                    (ICEM) and the
                    <a
                      href="/wiki/World_Association_for_Disaster_and_Emergency_Medicine"
                      title="World Association for Disaster and Emergency Medicine"
                      >World Association for Disaster and Emergency Medicine
                      Conference</a
                    >
                    (WADEM). ICEM was founded by the International Federation of
                    Emergency Medicine, while WADEM was started by an
                    organization of the same name. Additionally, in the 1990s
                    various national and regional emergency medicine
                    organizations began supporting the development of the
                    specialty in other countries, including the
                    <a
                      href="/wiki/American_College_of_Emergency_Physicians"
                      title="American College of Emergency Physicians"
                      >American College of Emergency Physicians</a
                    >, the
                    <a
                      href="/wiki/European_Society_for_Emergency_Medicine"
                      title="European Society for Emergency Medicine"
                      >European Society for Emergency Medicine</a
                    >, and the
                    <a
                      href="/w/index.php?title=Asian_Society_of_Emergency_Medicine&amp;action=edit&amp;redlink=1"
                      class="new"
                      title="Asian Society of Emergency Medicine (page does not exist)"
                      >Asian Society of Emergency Medicine</a
                    >.<sup id="cite_ref-alagappan2005_4-7" class="reference"
                      ><a href="#cite_note-alagappan2005-4"
                        ><span class="cite-bracket">[</span>4<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <p>
                    Furthermore, countries without mature EMSs began taking more
                    interest in developing them. One reason for this interest
                    was the overall improvement in healthcare in these
                    countries. Another was the increasing urbanization taking
                    place worldwide and the corresponding shift of focus from
                    <a
                      href="/wiki/Infectious_diseases"
                      class="mw-redirect"
                      title="Infectious diseases"
                      >infectious diseases</a
                    >
                    to
                    <a
                      href="/wiki/Trauma_(medicine)"
                      class="mw-redirect"
                      title="Trauma (medicine)"
                      >trauma</a
                    >
                    and cardiorespiratory diseases, which are better managed by
                    emergency medicine than prevention. In addition to these
                    developments, the aging population in many countries has led
                    to an increased need for emergency medical services. Also,
                    American popular culture, particularly television shows,<sup
                      id="cite_ref-Arnold_1-2"
                      class="reference"
                      ><a href="#cite_note-Arnold-1"
                        ><span class="cite-bracket">[</span>1<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    and "the demonstrated success of emergency medicine" in
                    countries with mature EMSs both led the public in many
                    countries to expect better emergency medical care.<sup
                      id="cite_ref-alagappan2005_4-8"
                      class="reference"
                      ><a href="#cite_note-alagappan2005-4"
                        ><span class="cite-bracket">[</span>4<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <p>
                    International emergency medicine organizations, whether
                    focused on relief or development, have also contributed to
                    the growth of the subspecialty. Relief organizations, such
                    as
                    <a
                      href="/wiki/Doctors_Without_Borders"
                      class="mw-redirect"
                      title="Doctors Without Borders"
                      >Doctors Without Borders</a
                    >
                    or
                    <a href="/wiki/AmeriCares" title="AmeriCares">AmeriCares</a
                    >, serve countries that do not have mature EMSs when health
                    catastrophes occur.<sup
                      id="cite_ref-Arnold_1-3"
                      class="reference"
                      ><a href="#cite_note-Arnold-1"
                        ><span class="cite-bracket">[</span>1<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    These organizations also serve to "enhance [the specialty's]
                    image in the international public eye".<sup
                      id="cite_ref-Arnold_1-4"
                      class="reference"
                      ><a href="#cite_note-Arnold-1"
                        ><span class="cite-bracket">[</span>1<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    Some development organizations, such as
                    <a
                      href="/w/index.php?title=Emergency_International&amp;action=edit&amp;redlink=1"
                      class="new"
                      title="Emergency International (page does not exist)"
                      >Emergency International</a
                    >
                    or the
                    <a
                      href="/wiki/International_Federation_for_Emergency_Medicine"
                      title="International Federation for Emergency Medicine"
                      >International Federation for Emergency Medicine</a
                    >, help establish and develop emergency care systems in
                    other countries by providing "ongoing educational and
                    organizational assistance."<sup
                      id="cite_ref-Arnold_1-5"
                      class="reference"
                      ><a href="#cite_note-Arnold-1"
                        ><span class="cite-bracket">[</span>1<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <div class="mw-heading mw-heading3">
                    <h3 id="Emergency_medicine_in_the_developing_world">
                      Emergency medicine in the developing world
                    </h3>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=6"
                        title="Edit section: Emergency medicine in the developing world"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
                  </div>
                  <p>
                    Motor vehicle crashes were a major factor that led to the
                    development of emergency medicine in the United States, the
                    United Kingdom, Australia, Canada, Hong Kong, and Singapore,
                    and they are a major factor leading countries to develop
                    their own emergency medical systems today. Such crashes
                    represent a leading cause of death for adolescents and young
                    adults, with the majority of deaths occurring in the
                    <a
                      href="/wiki/Developing_world"
                      class="mw-redirect"
                      title="Developing world"
                      >developing world</a
                    >.<sup id="cite_ref-Odero_6-0" class="reference"
                      ><a href="#cite_note-Odero-6"
                        ><span class="cite-bracket">[</span>6<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    In recent decades, while traffic fatalities have declined in
                    industrialized nations, they have been on the rise in
                    developing ones. Furthermore, developing nations tend to
                    have a higher proportion of fatalities per number of
                    vehicles for various reasons, including lower safety
                    standards for vehicles.<sup
                      id="cite_ref-Odero_6-1"
                      class="reference"
                      ><a href="#cite_note-Odero-6"
                        ><span class="cite-bracket">[</span>6<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    The lack of available emergency care in many developing
                    countries only serves to exacerbate this problem. This
                    higher rate of accident mortality per vehicle exists despite
                    the fact that there are fewer cars in Asia and Africa than
                    in the West. Odero et al. argue that this shows a need to
                    improve emergency medical care.<sup
                      id="cite_ref-Odero_6-2"
                      class="reference"
                      ><a href="#cite_note-Odero-6"
                        ><span class="cite-bracket">[</span>6<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <figure class="mw-default-size" typeof="mw:File/Thumb">
                    <a
                      href="/wiki/File:Car_crash.jpg"
                      class="mw-file-description"
                      ><img
                        src="//upload.wikimedia.org/wikipedia/commons/thumb/1/1b/Car_crash.jpg/250px-Car_crash.jpg"
                        decoding="async"
                        width="250"
                        height="188"
                        class="mw-file-element"
                        srcset="
                          //upload.wikimedia.org/wikipedia/commons/thumb/1/1b/Car_crash.jpg/500px-Car_crash.jpg 1.5x
                        "
                        data-file-width="2048"
                        data-file-height="1536"
                    /></a>
                    <figcaption>
                      Motor vehicle accidents such as this one are more likely
                      to be fatal in developing countries than in developed
                      ones.
                    </figcaption>
                  </figure>
                  <p>
                    Emergency medical care applies to other acute health
                    problems as well. Many illnesses with time-sensitive
                    elements are common in developing countries, including
                    severe infections,
                    <a
                      href="/wiki/Hypoxia_(medical)"
                      class="mw-redirect"
                      title="Hypoxia (medical)"
                      >hypoxia</a
                    >
                    caused by respiratory infections, dehydration caused by
                    <a
                      href="/wiki/Diarrhoea"
                      class="mw-redirect"
                      title="Diarrhoea"
                      >diarrhoea</a
                    >, intentional and unintentional injuries,
                    <a
                      href="/wiki/Postpartum_bleeding"
                      title="Postpartum bleeding"
                      >postpartum bleeding</a
                    >, and acute
                    <a
                      href="/wiki/Myocardial_infarction"
                      title="Myocardial infarction"
                      >myocardial infarction</a
                    >. These are potentially life-threatening conditions, yet
                    effective treatment is often unavailable for much of the
                    world's population.<sup
                      id="cite_ref-Razzak_7-0"
                      class="reference"
                      ><a href="#cite_note-Razzak-7"
                        ><span class="cite-bracket">[</span>7<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <p>
                    For instance, a 2008 study of medical systems in
                    <a href="/wiki/Zambia" title="Zambia">Zambia</a> published
                    by the
                    <a
                      href="/wiki/International_Anesthesia_Research_Society"
                      title="International Anesthesia Research Society"
                      >International Anesthesia Research Society</a
                    >
                    found that only 50 percent of hospitals had an emergency
                    medical system that transported patients. Just 24 percent of
                    ambulances carried oxygen, with only 40 percent carrying
                    drugs of any kind. Furthermore, only 29 intensive care beds
                    were available in all of the hospitals surveyed, and these
                    were only found in major hospitals. This implies that the
                    majority of
                    <a
                      href="/wiki/Intensive_care_medicine"
                      title="Intensive care medicine"
                      >critically ill</a
                    >
                    patients are receiving care in general hospital wards.<sup
                      id="cite_ref-Jochberger_8-0"
                      class="reference"
                      ><a href="#cite_note-Jochberger-8"
                        ><span class="cite-bracket">[</span>8<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <p>
                    Anderson et al. argue that, aside from acute care, emergency
                    medicine can also play a significant role in public health.
                    Vaccinations for many diseases such as
                    <a href="/wiki/Diphtheria" title="Diphtheria">diphtheria</a
                    >, <a href="/wiki/Tetanus" title="Tetanus">tetanus</a> and
                    <a
                      href="/wiki/Pertussis"
                      class="mw-redirect"
                      title="Pertussis"
                      >pertussis</a
                    >
                    can be administered by emergency departments, patients can
                    be targeted for specific interventions such as counseling
                    for
                    <a href="/wiki/Substance_abuse" title="Substance abuse"
                      >substance abuse</a
                    >, and conditions like
                    <a href="/wiki/Hypertension" title="Hypertension"
                      >hypertension</a
                    >
                    can be detected and treated. Emergency departments are
                    excellent locations to train health care providers and to
                    collect data, because of the high number of patients.
                    Emergency medicine also improves public health by preventing
                    secondary disease developing from an initial
                    <i>presentation</i> (initial symptoms), and it serves as the
                    first line of defense in disaster scenarios.<sup
                      id="cite_ref-9"
                      class="reference"
                      ><a href="#cite_note-9"
                        ><span class="cite-bracket">[</span>9<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <div class="mw-heading mw-heading3">
                    <h3 id="Models_of_emergency_care">
                      Models of emergency care
                    </h3>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=7"
                        title="Edit section: Models of emergency care"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
                  </div>
                  <p>
                    There are two primary models of emergency medicine: the
                    Anglo-American model, which relies on "bringing the patient
                    to the hospital", and the Franco-German model, which
                    operates through "bringing the hospital to the patient".<sup
                      id="cite_ref-Arnold_1-6"
                      class="reference"
                      ><a href="#cite_note-Arnold-1"
                        ><span class="cite-bracket">[</span>1<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    Thus, in the Anglo-American model, the patient is rapidly
                    transported by non-physician providers to definitive care
                    such as an emergency department in a hospital. Conversely,
                    the Franco-German approach has a physician, often an
                    <a
                      href="/wiki/Anesthesiologist"
                      class="mw-redirect"
                      title="Anesthesiologist"
                      >anesthesiologist</a
                    >, come to the patient and provide stabilizing care in the
                    field. The patient is then
                    <a href="/wiki/Triage" title="Triage">triaged</a> directly
                    to the appropriate department of a hospital. The
                    Anglo-American model is seen in nations such as Australia,
                    Canada, Ireland, New Zealand, the United Kingdom, and the
                    United States, while the Franco-German model is found in
                    European countries such as Austria, France, Germany, Poland,
                    Portugal, and Russia. Most developing emergency medical
                    systems, including those of China, Japan, the Philippines,
                    South Korea, and Taiwan, have been established along
                    Anglo-American lines, but little work exists to establish
                    the advantage of either system.<sup
                      id="cite_ref-Arnold_1-7"
                      class="reference"
                      ><a href="#cite_note-Arnold-1"
                        ><span class="cite-bracket">[</span>1<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <p>
                    Jeffrey Arnold and James Holliman have criticized the use of
                    these descriptors for emergency medical systems as an
                    oversimplification and a needless source of controversy.<sup
                      id="cite_ref-Holliman_10-0"
                      class="reference"
                      ><a href="#cite_note-Holliman-10"
                        ><span class="cite-bracket">[</span>10<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    Instead, Arnold and Holliman have proposed that other
                    groupings be used, such as classifying emergency medical
                    systems as following a specialty or multidisciplinary model.
                    Specialty systems would include those with physicians
                    dedicated to emergency medicine, whereas multidisciplinary
                    systems would encompass those that rely on physicians from
                    other disciplines to provide emergency care. Such an
                    approach would seek to categorize
                    <a
                      href="/wiki/Prehospital_care"
                      class="mw-redirect"
                      title="Prehospital care"
                      >pre-hospital care</a
                    >
                    separately from in-hospital systems.<sup
                      id="cite_ref-Holliman_10-1"
                      class="reference"
                      ><a href="#cite_note-Holliman-10"
                        ><span class="cite-bracket">[</span>10<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    Within Arnold and Holliman's understanding of emergency care
                    models, there is also an acknowledgement that current
                    Western models may be inadequate in the context of
                    developing nations. For instance, a
                    <a
                      href="/wiki/Cost%E2%80%93benefit_analysis"
                      title="Cost–benefit analysis"
                      >cost–benefit analysis</a
                    >
                    found that creating an EMS system in
                    <a href="/wiki/Kuala_Lumpur" title="Kuala Lumpur"
                      >Kuala Lumpur</a
                    >
                    that met U.S. standards for
                    <a href="/wiki/Cardiac_arrest" title="Cardiac arrest"
                      >cardiac arrest</a
                    >
                    response (85 percent of patients receive
                    <a href="/wiki/Defibrillation" title="Defibrillation"
                      >defibrillation</a
                    >
                    within 6 minutes) would cost US$2.5 million and only save
                    four neurologically intact lives per year. The primary
                    <a
                      href="/wiki/Dependent_and_independent_variables"
                      title="Dependent and independent variables"
                      >variable</a
                    >
                    responsible for that result is the relatively young
                    demography of Kuala Lumpur, meaning that comparatively few
                    cardiac-related deaths occur.<sup
                      id="cite_ref-11"
                      class="reference"
                      ><a href="#cite_note-11"
                        ><span class="cite-bracket">[</span>11<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <figure class="mw-default-size" typeof="mw:File/Thumb">
                    <a
                      href="/wiki/File:Ambulance_NYC.jpg"
                      class="mw-file-description"
                      ><img
                        src="//upload.wikimedia.org/wikipedia/commons/thumb/c/cd/Ambulance_NYC.jpg/250px-Ambulance_NYC.jpg"
                        decoding="async"
                        width="250"
                        height="139"
                        class="mw-file-element"
                        srcset="
                          //upload.wikimedia.org/wikipedia/commons/thumb/c/cd/Ambulance_NYC.jpg/500px-Ambulance_NYC.jpg 1.5x
                        "
                        data-file-width="1981"
                        data-file-height="1105"
                    /></a>
                    <figcaption>
                      An ambulance like this one is too expensive and
                      impractical for use in many developing countries.
                    </figcaption>
                  </figure>
                  <p>
                    An example of a developing nation establishing its own model
                    of emergency medicine may be seen in southern Brazil.
                    Elements of both of the major conventional models have been
                    incorporated, with the EMS system following French
                    influences and the ambulances being staffed by physicians,
                    while an American approach to emergency medical residency
                    training is also present.<sup
                      id="cite_ref-12"
                      class="reference"
                      ><a href="#cite_note-12"
                        ><span class="cite-bracket">[</span>12<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <div class="mw-heading mw-heading2">
                    <h2 id="Role_in_overall_health_system">
                      Role in overall health system
                    </h2>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=8"
                        title="Edit section: Role in overall health system"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
                  </div>
                  <div class="mw-heading mw-heading3">
                    <h3 id="Developed_countries">Developed countries</h3>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=9"
                        title="Edit section: Developed countries"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
                  </div>
                  <p>
                    In developed counties, training programs specifically
                    relating to the international practice of emergency medicine
                    are now available within many emergency medicine
                    residencies. The curriculum that should be covered by such
                    programs has been the subject of much discussion. Patient
                    care, medical knowledge, practice-based learning,
                    communication skills, professionalism, and system-based
                    practice are the basic six competencies required of programs
                    approved by the
                    <a
                      href="/wiki/Accreditation_Council_for_Graduate_Medical_Education"
                      title="Accreditation Council for Graduate Medical Education"
                      >Accreditation Council for Graduate Medical Education</a
                    >, but the application of these goals can take many
                    forms.<sup id="cite_ref-Burdick_3-1" class="reference"
                      ><a href="#cite_note-Burdick-3"
                        ><span class="cite-bracket">[</span>3<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    The breadth of skills needed in international emergency
                    medicine make it unlikely that one standardized program
                    could fulfill the training needs for every scenario. One
                    Australian study found that the primary topics covered by
                    U.S. fellowship programs were emergency medicine systems
                    development, humanitarian relief,
                    <a
                      href="/wiki/Disaster_management"
                      class="mw-redirect"
                      title="Disaster management"
                      >disaster management</a
                    >, public health,
                    <a href="/wiki/Travel_medicine" title="Travel medicine"
                      >travel</a
                    >
                    and
                    <a
                      href="/wiki/Field_medicine"
                      class="mw-redirect"
                      title="Field medicine"
                      >field medicine</a
                    >, program administration, and academic skills.<sup
                      id="cite_ref-Sistenich_2-1"
                      class="reference"
                      ><a href="#cite_note-Sistenich-2"
                        ><span class="cite-bracket">[</span>2<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    Its authors argue that attempting to cover all of those
                    areas may be unrealistic and that a more targeted focus on
                    acquiring necessary skills might be more productive.<sup
                      id="cite_ref-Sistenich_2-2"
                      class="reference"
                      ><a href="#cite_note-Sistenich-2"
                        ><span class="cite-bracket">[</span>2<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <p>
                    After such training is completed, or even without any EMS
                    training, working in or visiting other nations is one way
                    physicians can participate in international emergency
                    medicine. Some physicians choose to pursue their careers
                    overseas, while others opt for shorter trips. For example, a
                    team of U.S. physicians spent seven months helping establish
                    a new emergency department and emergency residency program
                    in <a href="/wiki/Hangzhou" title="Hangzhou">Hangzhou</a>,
                    China.<sup id="cite_ref-13" class="reference"
                      ><a href="#cite_note-13"
                        ><span class="cite-bracket">[</span>13<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    Such exchanges can be mutually beneficial. For instance, 23
                    to 28 percent of all physicians in Australia, the United
                    States, the United Kingdom and Canada received their
                    training at medical schools outside of the country in which
                    they currently practice.<sup
                      id="cite_ref-14"
                      class="reference"
                      ><a href="#cite_note-14"
                        ><span class="cite-bracket">[</span>14<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <div class="mw-heading mw-heading3">
                    <h3 id="Developing_countries">Developing countries</h3>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=10"
                        title="Edit section: Developing countries"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
                  </div>
                  <figure class="mw-default-size" typeof="mw:File/Thumb">
                    <a
                      href="/wiki/File:Africa_satellite_plane.jpg"
                      class="mw-file-description"
                      ><img
                        src="//upload.wikimedia.org/wikipedia/commons/thumb/6/6d/Africa_satellite_plane.jpg/250px-Africa_satellite_plane.jpg"
                        decoding="async"
                        width="250"
                        height="263"
                        class="mw-file-element"
                        srcset="
                          //upload.wikimedia.org/wikipedia/commons/thumb/6/6d/Africa_satellite_plane.jpg/500px-Africa_satellite_plane.jpg 1.5x
                        "
                        data-file-width="8460"
                        data-file-height="8900"
                    /></a>
                    <figcaption>
                      According to Alagappan et al., Africa is the continent
                      most in need of developing emergency medical systems.<sup
                        id="cite_ref-alagappan2005_4-9"
                        class="reference"
                        ><a href="#cite_note-alagappan2005-4"
                          ><span class="cite-bracket">[</span>4<span
                            class="cite-bracket"
                            >]</span
                          ></a
                        ></sup
                      >
                    </figcaption>
                  </figure>
                  <p>
                    The experience of international emergency medicine in
                    developing countries is in some ways the opposite of that of
                    developed ones. As of the 2000s, developing countries are
                    attempting to establish effective systems of care and
                    recognized specialty programs with assistance from health
                    care providers from the developed world. In 2005, there were
                    only a few countries with advanced emergency medical
                    systems, and a far greater number (50+) that were in the
                    process of developing those systems. The process of
                    development usually begins in academia and patient care,
                    followed by administrative and economic concerns, and
                    finally health policy and agendas.<sup
                      id="cite_ref-15"
                      class="reference"
                      ><a href="#cite_note-15"
                        ><span class="cite-bracket">[</span>15<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <p>
                    Given the limited resources of many developing nations,
                    funding vitally effects how emergency medicine fits into the
                    health system.
                    <a
                      href="/wiki/Preventive_care"
                      class="mw-redirect"
                      title="Preventive care"
                      >Preventive care</a
                    >
                    is a crucial part of healthcare in developing countries, and
                    it may be difficult to budget for emergency medicine without
                    cutting into those resources. This is a particular problem
                    for poorer nations such as Zambia, which had a per capita
                    health expenditure of 23 US dollars in 2003.<sup
                      id="cite_ref-Jochberger_8-1"
                      class="reference"
                      ><a href="#cite_note-Jochberger-8"
                        ><span class="cite-bracket">[</span>8<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    Regardless of the amount of preventive care available,
                    health problems requiring immediate attention will still
                    occur, and emergency medical programs could increase access
                    to care. Kobusingye et al. argue that expanding emergency
                    medicine does not need to be unreasonably expensive,
                    particularly if developing countries focus on low-cost but
                    effective treatments administered by
                    <a
                      href="/wiki/Certified_first_responder"
                      title="Certified first responder"
                      >first responders</a
                    >.<sup id="cite_ref-16" class="reference"
                      ><a href="#cite_note-16"
                        ><span class="cite-bracket">[</span>16<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <div class="mw-heading mw-heading2">
                    <h2 id="Initiatives_to_expand_emergency_medicine">
                      Initiatives to expand emergency medicine
                    </h2>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=11"
                        title="Edit section: Initiatives to expand emergency medicine"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
                  </div>
                  <div class="mw-heading mw-heading3">
                    <h3 id="Curriculum_development">Curriculum development</h3>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=12"
                        title="Edit section: Curriculum development"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
                  </div>
                  <p>
                    Hobgood et al. argue that one key component in equipping
                    nations to develop emergency medical systems is to identify
                    the aspects of training that are essential for health care
                    providers. In their view, a standard curriculum is useful
                    for identifying core issues, even if countries have very
                    different needs and resources. To address this goal, the
                    <a
                      href="/wiki/International_Federation_for_Emergency_Medicine"
                      title="International Federation for Emergency Medicine"
                      >International Federation for Emergency Medicine</a
                    >
                    developed a model curriculum in 2009.<sup
                      id="cite_ref-Slinger_17-0"
                      class="reference"
                      ><a href="#cite_note-Slinger-17"
                        ><span class="cite-bracket">[</span>17<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    This initiative seeks to provide a minimum basic standard
                    that can be tailored to the specific needs of the various
                    nations implementing training in emergency medicine. It is
                    targeted towards all medical students in order to produce a
                    minimum competency in emergency care for all physicians,
                    regardless of their specialty.<sup
                      id="cite_ref-Slinger_17-1"
                      class="reference"
                      ><a href="#cite_note-Slinger-17"
                        ><span class="cite-bracket">[</span>17<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <div class="mw-heading mw-heading3">
                    <h3 id="Transferring_knowledge">Transferring knowledge</h3>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=13"
                        title="Edit section: Transferring knowledge"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
                  </div>
                  <p>
                    Countries with decades of experience in comprehensive
                    emergency medical systems have expertise that nations that
                    are just beginning emergency medical programs lack. Thus,
                    there exists considerable opportunity for the transfer of
                    knowledge to assist newly founded programs. Such transfers
                    may be made either from a distance or in person. For
                    instance, the International Emergency Medicine Fellowship at
                    the
                    <a
                      href="/wiki/University_of_Toronto"
                      title="University of Toronto"
                      >University of Toronto</a
                    >
                    sent a three-person team to
                    <a href="/wiki/Cluj-Napoca" title="Cluj-Napoca"
                      >Cluj-Napoca</a
                    >, <a href="/wiki/Romania" title="Romania">Romania</a>, to
                    promote the local development of emergency medicine. An
                    assessment of the present status was performed that
                    identified targets for improvement in physical plant
                    organization and patient flow; staffing, staff education,
                    equipment, medication and supplies; and
                    <a
                      href="/wiki/Infection_control"
                      class="mw-redirect"
                      title="Infection control"
                      >infection control</a
                    >
                    practices. Following these designations, plans regarding
                    these areas were collaboratively drawn up and then
                    implemented, partially through international exchange
                    trips.<sup id="cite_ref-18" class="reference"
                      ><a href="#cite_note-18"
                        ><span class="cite-bracket">[</span>18<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <p>
                    Another conduit for the transfer of knowledge is the
                    <a
                      href="/wiki/International_Conference_on_Emergency_Medicine"
                      title="International Conference on Emergency Medicine"
                      >International Conference on Emergency Medicine</a
                    >, a conference held every two years for worldwide emergency
                    physicians by the
                    <a
                      href="/wiki/International_Federation_for_Emergency_Medicine"
                      title="International Federation for Emergency Medicine"
                      >International Federation for Emergency Medicine</a
                    >
                    (IFEM). In 2012, the conference took place in Dublin,
                    Ireland.<sup id="cite_ref-19" class="reference"
                      ><a href="#cite_note-19"
                        ><span class="cite-bracket">[</span>19<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    The organization was founded in 1991 by four national
                    emergency physician organizations: the
                    <a
                      href="/wiki/American_College_of_Emergency_Physicians"
                      title="American College of Emergency Physicians"
                      >American College of Emergency Physicians</a
                    >, the
                    <a
                      href="/wiki/British_Association_for_Emergency_Medicine"
                      class="mw-redirect"
                      title="British Association for Emergency Medicine"
                      >British Association for Emergency Medicine</a
                    >, the
                    <a
                      href="/wiki/Canadian_Association_of_Emergency_Physicians"
                      title="Canadian Association of Emergency Physicians"
                      >Canadian Association of Emergency Physicians</a
                    >, and the
                    <a
                      href="/wiki/Australasian_College_for_Emergency_Medicine"
                      title="Australasian College for Emergency Medicine"
                      >Australasian College for Emergency Medicine</a
                    >.<sup id="cite_ref-20" class="reference"
                      ><a href="#cite_note-20"
                        ><span class="cite-bracket">[</span>20<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    The conference rotated between the founding members until
                    2010, when it was held in Singapore.<sup
                      id="cite_ref-holliman_21-0"
                      class="reference"
                      ><a href="#cite_note-holliman-21"
                        ><span class="cite-bracket">[</span>21<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    Many new members have been accepted since the mid-1990s,
                    when the IFEM decided to open up membership to other
                    nations' emergency medicine organizations; the conference
                    will rotate to them as well.<sup
                      id="cite_ref-holliman_21-1"
                      class="reference"
                      ><a href="#cite_note-holliman-21"
                        ><span class="cite-bracket">[</span>21<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    For instance, in 2014 the conference will be hosted in
                    <a href="/wiki/Hong_Kong" title="Hong Kong">Hong Kong</a>
                    and in 2016 it will be held in
                    <a href="/wiki/Cape_Town" title="Cape Town">Cape Town</a>,
                    <a href="/wiki/South_Africa" title="South Africa"
                      >South Africa</a
                    >.<sup id="cite_ref-22" class="reference"
                      ><a href="#cite_note-22"
                        ><span class="cite-bracket">[</span>22<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <p>
                    There are other conferences on international emergency
                    medicine as well, including the one that the
                    <a
                      href="/wiki/World_Association_for_Disaster_and_Emergency_Medicine"
                      title="World Association for Disaster and Emergency Medicine"
                      >World Association for Disaster and Emergency Medicine</a
                    >
                    (WADEM) has held every two years since 1987. However, WADEM
                    focuses more on
                    <a href="/wiki/Disaster_medicine" title="Disaster medicine"
                      >disaster medicine</a
                    >
                    than emergency medicine system development, and many of its
                    member physicians are not specialists in emergency medicine.
                    Additionally, the
                    <a
                      href="/wiki/European_Society_for_Emergency_Medicine"
                      title="European Society for Emergency Medicine"
                      >European Society for Emergency Medicine</a
                    >
                    (EuSEM) has hosted an annual conference since 1998. EuSEM
                    also publishes
                    <i
                      ><a
                        href="/wiki/The_European_Journal_of_Emergency_Medicine"
                        class="mw-redirect"
                        title="The European Journal of Emergency Medicine"
                        >The European Journal of Emergency Medicine</a
                      ></i
                    >, develops recommendations for emergency medicine standards
                    for European countries, and supports a disaster medicine
                    training center and degree program in
                    <a href="/wiki/San_Marino" title="San Marino">San Marino</a
                    >. The Asian Society for Emergency Medicine (Asian Society),
                    which was founded in 1998, holds its own biennial
                    conference. In addition to that, the Asian Society, like the
                    EuSEM, develops curriculum recommendations for Asian
                    countries.<sup
                      id="cite_ref-alagappan2005_4-10"
                      class="reference"
                      ><a href="#cite_note-alagappan2005-4"
                        ><span class="cite-bracket">[</span>4<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <div class="mw-heading mw-heading3">
                    <h3 id="Developing_emergency_medicine_as_a_specialty">
                      Developing emergency medicine as a specialty
                    </h3>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=14"
                        title="Edit section: Developing emergency medicine as a specialty"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
                  </div>
                  <p>
                    One way to advance emergency medical care is to obtain the
                    recognition of emergency medicine as a specialty in
                    countries that currently lack it. Without such recognition,
                    it is difficult to set up training programs or recruit
                    potential students, as they face the uncertainty of training
                    to obtain a credential that may end up being useless to
                    them. Recognition increases the visibility and prestige of
                    the profession and promotes other efforts to advance its
                    development.
                    <a href="/wiki/Botswana" title="Botswana">Botswana</a> may
                    serve as a case study. Its recent recognition of emergency
                    medicine as a specialty has been closely accompanied by the
                    creation of the
                    <a
                      href="/w/index.php?title=Botswana_Society_for_Emergency_Care&amp;action=edit&amp;redlink=1"
                      class="new"
                      title="Botswana Society for Emergency Care (page does not exist)"
                      >Botswana Society for Emergency Care</a
                    >, the establishment of a Resuscitation Training Centre and
                    a Trauma Research Centre at the
                    <a
                      href="/wiki/University_of_Botswana"
                      title="University of Botswana"
                      >University of Botswana</a
                    >, and the formation of a committee to design a national
                    policy for pre-hospital care.<sup
                      id="cite_ref-Caruso_23-0"
                      class="reference"
                      ><a href="#cite_note-Caruso-23"
                        ><span class="cite-bracket">[</span>23<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <p>
                    An alternate route for developing emergency medicine is to
                    provide additional training for other specialists to equip
                    them to practice in emergency medicine. This has the benefit
                    of being more rapid to implement, as physicians already
                    trained in other areas can add the necessary emergency
                    skills to their repertoire. However, after the initial
                    expansion it is difficult for emergency medicine to progress
                    further in nations that adopt this strategy, as the
                    retrained practitioners identify more with their original
                    specialty and have less incentive to continue to press for
                    further innovations in emergency medicine.<sup
                      id="cite_ref-Holliman_10-2"
                      class="reference"
                      ><a href="#cite_note-Holliman-10"
                        ><span class="cite-bracket">[</span>10<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <div class="mw-heading mw-heading2">
                    <h2 id="Challenges">Challenges</h2>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=15"
                        title="Edit section: Challenges"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
                  </div>
                  <div class="mw-heading mw-heading3">
                    <h3 id="Training">Training</h3>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=16"
                        title="Edit section: Training"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
                  </div>
                  <p>
                    Educational opportunities in emergency medicine are not
                    available in many countries, and even when present, they are
                    often in their infancy. Botswana opened its first medical
                    school in 2009, with a program in emergency medicine
                    following in 2011.<sup
                      id="cite_ref-Caruso_23-1"
                      class="reference"
                      ><a href="#cite_note-Caruso-23"
                        ><span class="cite-bracket">[</span>23<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    The program aims to train four to six physicians in
                    emergency medicine each year. Limitations on in-country
                    training mean that the program includes six months of
                    training at an international site. The organization of the
                    program is modeled on South Africa's program due to the
                    similarities in resource constraints and
                    <a href="/wiki/Disease_burden" title="Disease burden"
                      >disease burdens</a
                    >
                    and the eagerness of
                    <a
                      href="/w/index.php?title=College_of_Emergency_Medicine_of_South_Africa&amp;action=edit&amp;redlink=1"
                      class="new"
                      title="College of Emergency Medicine of South Africa (page does not exist)"
                      >College of Emergency Medicine of South Africa</a
                    >
                    and
                    <a
                      href="/wiki/Emergency_Medicine_Society_of_South_Africa"
                      title="Emergency Medicine Society of South Africa"
                      >Emergency Medicine Society of South Africa</a
                    >
                    to support the expansion of emergency medicine. Two years of
                    clinical practice are required before entering the residency
                    program, as in the South African and Australian
                    approaches.<sup id="cite_ref-Caruso_23-2" class="reference"
                      ><a href="#cite_note-Caruso-23"
                        ><span class="cite-bracket">[</span>23<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <p>
                    To deal with this shortage of educational opportunities,
                    Scott Weiner et al. suggest that countries with developed
                    emergency medical systems should focus on training the
                    trainers. This, he believes, is a sustainable approach to
                    promote the development of emergency medicine worldwide. It
                    works by sending developed country health care workers to
                    equip a small group of trainees with the necessary skills to
                    then go on and teach the concepts to others. As such, it may
                    be able to leverage the insights of developed emergency
                    medical systems while remaining sustainable, as the newly
                    trained trainers continue to spread the knowledge. The
                    Tuscan Emergency Medicine Initiative is an example, with
                    physicians from other specialties currently working in
                    emergency departments being taught how to teach a new group
                    of emergency medical specialists.<sup
                      id="cite_ref-24"
                      class="reference"
                      ><a href="#cite_note-24"
                        ><span class="cite-bracket">[</span>24<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <div class="mw-heading mw-heading3">
                    <h3 id="Emergency_transport">Emergency transport</h3>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=17"
                        title="Edit section: Emergency transport"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
                  </div>
                  <p>
                    The limitations on resources available in developing
                    countries are particularly evident in the area of emergency
                    transport.
                    <a href="/wiki/Ambulance" title="Ambulance">Ambulances</a>,
                    the developed country standard, are costly and not practical
                    for the road conditions present in many countries. Indeed,
                    there may be no roads at all. One study found that modes of
                    transport as diverse as motorboats, canoes, bicycles with
                    trailers, tricycles with platforms, tractors with trailers,
                    reconditioned vehicles, and ox carts were used for emergency
                    transport.<sup id="cite_ref-Razzak_7-1" class="reference"
                      ><a href="#cite_note-Razzak-7"
                        ><span class="cite-bracket">[</span>7<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <p>
                    In more advanced developing countries, establishing
                    ambulance transport systems is more feasible, but still
                    requires considerable expertise and planning. Prior to 2004,
                    <a href="/wiki/Pakistan" title="Pakistan">Pakistan</a> did
                    not have an organized emergency medical system.<sup
                      id="cite_ref-Waseem_25-0"
                      class="reference"
                      ><a href="#cite_note-Waseem-25"
                        ><span class="cite-bracket">[</span>25<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    In that year,
                    <a href="/wiki/Rescue_1122" title="Rescue 1122"
                      >Rescue 1122</a
                    >
                    was launched as a professional pre-hospital emergency
                    service, and it has managed to achieve an average response
                    time of 7 minutes, comparable to that of developed nations.
                    Some of the critical factors in its success included local
                    manufacture of vehicles, training instructors to certify
                    <a
                      href="/wiki/Emergency_medical_technician"
                      title="Emergency medical technician"
                      >emergency medical technicians</a
                    >, adopting training materials to the local context, and
                    branching out to include fire and rescue service response
                    under a united command structure.<sup
                      id="cite_ref-Waseem_25-1"
                      class="reference"
                      ><a href="#cite_note-Waseem-25"
                        ><span class="cite-bracket">[</span>25<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <div class="mw-heading mw-heading3">
                    <h3 id="Resources">Resources</h3>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=18"
                        title="Edit section: Resources"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
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                          <div class="thumbcaption">Misoprostol pills</div>
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                          Alternative treatments for resource-constrained
                          environments
                        </div>
                      </div>
                    </div>
                  </div>
                  <p>
                    The vital nature of coping with the lack of resources
                    available in international emergency medicine may be seen in
                    the proportion of scientific articles that grapple with the
                    topic. Of the top 27 articles identified by a review of the
                    international emergency medicine literature from 2010, 14
                    were classified as dealing with the practice of emergency
                    medicine in resource-constrained environments.<sup
                      id="cite_ref-Aschekenasy_26-0"
                      class="reference"
                      ><a href="#cite_note-Aschekenasy-26"
                        ><span class="cite-bracket">[</span>26<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    A new dimension of thought is that of the isolated subject
                    of technology for trauma care as published in the World
                    Journal of Surgery by
                    <a href="/wiki/Mihir_Shah" title="Mihir Shah">Mihir Shah</a>
                    et al.<sup id="cite_ref-27" class="reference"
                      ><a href="#cite_note-27"
                        ><span class="cite-bracket">[</span>27<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    Topics covered included the use of the
                    <a href="/wiki/Broselow_tape" title="Broselow tape"
                      >Broselow tape</a
                    >
                    as the best estimate for children's weight, green bananas as
                    an effective treatment for diarrhea, and
                    <a href="/wiki/Misoprostol" title="Misoprostol"
                      >misoprostol</a
                    >
                    as a potential alternative for postpartum hemorrhage when
                    <a href="/wiki/Oxytocin" title="Oxytocin">oxytocin</a> is
                    not available.<sup
                      id="cite_ref-Aschekenasy_26-1"
                      class="reference"
                      ><a href="#cite_note-Aschekenasy-26"
                        ><span class="cite-bracket">[</span>26<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <div class="mw-heading mw-heading3">
                    <h3 id="Lack_of_research">Lack of research</h3>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=19"
                        title="Edit section: Lack of research"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
                  </div>
                  <p>
                    Despite the thought that increasing availability to
                    emergency medicine will improve patient outcomes, little
                    empirical evidence exists to directly support that claim,
                    even in developed countries. Between 1985 and 1998 only 54
                    <a
                      href="/wiki/Randomized_controlled_trial"
                      title="Randomized controlled trial"
                      >randomized controlled trials</a
                    >
                    related to emergency medical services were published,
                    implying that much of the current standard of care rests
                    upon meager support.<sup
                      id="cite_ref-Holliman_10-3"
                      class="reference"
                      ><a href="#cite_note-Holliman-10"
                        ><span class="cite-bracket">[</span>10<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    A similar lack of direct proof exists for the effectiveness
                    of international assistance in promoting emergency medicine
                    in other countries. Although it may seem that such efforts
                    must improve health, the failure to quantify international
                    emergency medicine's impact renders it more difficult to
                    identify the best practices and target areas in which the
                    most benefit may be achieved.<sup
                      id="cite_ref-Arnold_1-8"
                      class="reference"
                      ><a href="#cite_note-Arnold-1"
                        ><span class="cite-bracket">[</span>1<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <p>
                    A development in recent years that seeks to address these
                    issues has been termed
                    <a
                      href="/wiki/Evidence-based_medicine"
                      title="Evidence-based medicine"
                      >evidence-based medicine</a
                    >. As its name suggests, this approach strives to rigorously
                    study the effects of different interventions instead of
                    relying on logic or tradition.<sup
                      id="cite_ref-Arnold_1-9"
                      class="reference"
                      ><a href="#cite_note-Arnold-1"
                        ><span class="cite-bracket">[</span>1<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                    Jeffrey Arnold argues that its application worldwide could
                    lead to the boon of sharing best practices between emergency
                    medicine practitioners in various countries, thus advancing
                    the current standard of emergency care.<sup
                      id="cite_ref-Arnold_1-10"
                      class="reference"
                      ><a href="#cite_note-Arnold-1"
                        ><span class="cite-bracket">[</span>1<span
                          class="cite-bracket"
                          >]</span
                        ></a
                      ></sup
                    >
                  </p>
                  <div class="mw-heading mw-heading2">
                    <h2 id="References">References</h2>
                    <span class="mw-editsection"
                      ><span class="mw-editsection-bracket">[</span
                      ><a
                        href="/w/index.php?title=International_emergency_medicine&amp;action=edit&amp;section=20"
                        title="Edit section: References"
                        ><span>edit</span></a
                      ><span class="mw-editsection-bracket">]</span></span
                    >
                  </div>
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                    <ol class="references">
                      <li id="cite_note-Arnold-1">
                        <span class="mw-cite-backlink"
                          >^
                          <a href="#cite_ref-Arnold_1-0"
                            ><sup
                              ><i><b>a</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Arnold_1-1"
                            ><sup
                              ><i><b>b</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Arnold_1-2"
                            ><sup
                              ><i><b>c</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Arnold_1-3"
                            ><sup
                              ><i><b>d</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Arnold_1-4"
                            ><sup
                              ><i><b>e</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Arnold_1-5"
                            ><sup
                              ><i><b>f</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Arnold_1-6"
                            ><sup
                              ><i><b>g</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Arnold_1-7"
                            ><sup
                              ><i><b>h</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Arnold_1-8"
                            ><sup
                              ><i><b>i</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Arnold_1-9"
                            ><sup
                              ><i><b>j</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Arnold_1-10"
                            ><sup
                              ><i><b>k</b></i></sup
                            ></a
                          ></span
                        >
                        <span class="reference-text"
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                          ><cite
                            id="CITEREFArnold1999"
                            class="citation journal cs1"
                            >Arnold, Jeffrey L. (January 1999). "International
                            Emergency Medicine and the Recent Development of
                            Emergency Medicine Worldwide".
                            <i>Annals of Emergency Medicine</i>. <b>33</b> (1):
                            <span class="nowrap">97–</span>103.
                            <a
                              href="/wiki/Doi_(identifier)"
                              class="mw-redirect"
                              title="Doi (identifier)"
                              >doi</a
                            >:<a
                              rel="nofollow"
                              class="external text"
                              href="https://doi.org/10.1016%2Fs0196-0644%2899%2970424-5"
                              >10.1016/s0196-0644(99)70424-5</a
                            >.
                            <a
                              href="/wiki/PMID_(identifier)"
                              class="mw-redirect"
                              title="PMID (identifier)"
                              >PMID</a
                            >&nbsp;<a
                              rel="nofollow"
                              class="external text"
                              href="https://pubmed.ncbi.nlm.nih.gov/9867895"
                              >9867895</a
                            >.</cite
                          ><span
                            title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Annals+of+Emergency+Medicine&amp;rft.atitle=International+Emergency+Medicine+and+the+Recent+Development+of+Emergency+Medicine+Worldwide&amp;rft.volume=33&amp;rft.issue=1&amp;rft.pages=97-103&amp;rft.date=1999-01&amp;rft_id=info%3Adoi%2F10.1016%2Fs0196-0644%2899%2970424-5&amp;rft_id=info%3Apmid%2F9867895&amp;rft.aulast=Arnold&amp;rft.aufirst=Jeffrey+L.&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AInternational+emergency+medicine"
                            class="Z3988"
                          ></span
                        ></span>
                      </li>
                      <li id="cite_note-Sistenich-2">
                        <span class="mw-cite-backlink"
                          >^
                          <a href="#cite_ref-Sistenich_2-0"
                            ><sup
                              ><i><b>a</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Sistenich_2-1"
                            ><sup
                              ><i><b>b</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Sistenich_2-2"
                            ><sup
                              ><i><b>c</b></i></sup
                            ></a
                          ></span
                        >
                        <span class="reference-text"
                          ><link
                            rel="mw-deduplicated-inline-style"
                            href="mw-data:TemplateStyles:r1238218222" /><cite
                            id="CITEREFSistenich2012"
                            class="citation journal cs1"
                            >Sistenich, Vera (August 2012).
                            <a
                              rel="nofollow"
                              class="external text"
                              href="https://zenodo.org/record/1038653"
                              >"International Emergency Medicine: How to Train
                              for It"</a
                            >. <i>Emergency Medicine Australasia</i>.
                            <b>24</b> (4): <span class="nowrap">435–</span>41.
                            <a
                              href="/wiki/Doi_(identifier)"
                              class="mw-redirect"
                              title="Doi (identifier)"
                              >doi</a
                            >:<a
                              rel="nofollow"
                              class="external text"
                              href="https://doi.org/10.1111%2Fj.1742-6723.2012.01563.x"
                              >10.1111/j.1742-6723.2012.01563.x</a
                            >.
                            <a
                              href="/wiki/PMID_(identifier)"
                              class="mw-redirect"
                              title="PMID (identifier)"
                              >PMID</a
                            >&nbsp;<a
                              rel="nofollow"
                              class="external text"
                              href="https://pubmed.ncbi.nlm.nih.gov/22862762"
                              >22862762</a
                            >.
                            <a
                              href="/wiki/S2CID_(identifier)"
                              class="mw-redirect"
                              title="S2CID (identifier)"
                              >S2CID</a
                            >&nbsp;<a
                              rel="nofollow"
                              class="external text"
                              href="https://api.semanticscholar.org/CorpusID:205888668"
                              >205888668</a
                            >.</cite
                          ><span
                            title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Emergency+Medicine+Australasia&amp;rft.atitle=International+Emergency+Medicine%3A+How+to+Train+for+It&amp;rft.volume=24&amp;rft.issue=4&amp;rft.pages=435-41&amp;rft.date=2012-08&amp;rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A205888668%23id-name%3DS2CID&amp;rft_id=info%3Apmid%2F22862762&amp;rft_id=info%3Adoi%2F10.1111%2Fj.1742-6723.2012.01563.x&amp;rft.aulast=Sistenich&amp;rft.aufirst=Vera&amp;rft_id=https%3A%2F%2Fzenodo.org%2Frecord%2F1038653&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AInternational+emergency+medicine"
                            class="Z3988"
                          ></span
                        ></span>
                      </li>
                      <li id="cite_note-Burdick-3">
                        <span class="mw-cite-backlink"
                          >^
                          <a href="#cite_ref-Burdick_3-0"
                            ><sup
                              ><i><b>a</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Burdick_3-1"
                            ><sup
                              ><i><b>b</b></i></sup
                            ></a
                          ></span
                        >
                        <span class="reference-text"
                          ><link
                            rel="mw-deduplicated-inline-style"
                            href="mw-data:TemplateStyles:r1238218222" /><cite
                            id="CITEREFBurdickHauswaldIserson2010"
                            class="citation journal cs1"
                            >Burdick, William P.; Hauswald, Mark; Iserson,
                            Kenneth V. (2010).
                            <a
                              rel="nofollow"
                              class="external text"
                              href="https://doi.org/10.1111%2Fj.1553-2712.2010.00805.x"
                              >"International Emergency Medicine"</a
                            >. <i>Academic Emergency Medicine</i>.
                            <b>17</b> (7): <span class="nowrap">758–</span>61.
                            <a
                              href="/wiki/Doi_(identifier)"
                              class="mw-redirect"
                              title="Doi (identifier)"
                              >doi</a
                            >:<span
                              class="id-lock-free"
                              title="Freely accessible"
                              ><a
                                rel="nofollow"
                                class="external text"
                                href="https://doi.org/10.1111%2Fj.1553-2712.2010.00805.x"
                                >10.1111/j.1553-2712.2010.00805.x</a
                              ></span
                            >.
                            <a
                              href="/wiki/PMID_(identifier)"
                              class="mw-redirect"
                              title="PMID (identifier)"
                              >PMID</a
                            >&nbsp;<a
                              rel="nofollow"
                              class="external text"
                              href="https://pubmed.ncbi.nlm.nih.gov/20653591"
                              >20653591</a
                            >.</cite
                          ><span
                            title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Academic+Emergency+Medicine&amp;rft.atitle=International+Emergency+Medicine&amp;rft.volume=17&amp;rft.issue=7&amp;rft.pages=758-61&amp;rft.date=2010&amp;rft_id=info%3Adoi%2F10.1111%2Fj.1553-2712.2010.00805.x&amp;rft_id=info%3Apmid%2F20653591&amp;rft.aulast=Burdick&amp;rft.aufirst=William+P.&amp;rft.au=Hauswald%2C+Mark&amp;rft.au=Iserson%2C+Kenneth+V.&amp;rft_id=https%3A%2F%2Fdoi.org%2F10.1111%252Fj.1553-2712.2010.00805.x&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AInternational+emergency+medicine"
                            class="Z3988"
                          ></span
                        ></span>
                      </li>
                      <li id="cite_note-alagappan2005-4">
                        <span class="mw-cite-backlink"
                          >^
                          <a href="#cite_ref-alagappan2005_4-0"
                            ><sup
                              ><i><b>a</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-alagappan2005_4-1"
                            ><sup
                              ><i><b>b</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-alagappan2005_4-2"
                            ><sup
                              ><i><b>c</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-alagappan2005_4-3"
                            ><sup
                              ><i><b>d</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-alagappan2005_4-4"
                            ><sup
                              ><i><b>e</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-alagappan2005_4-5"
                            ><sup
                              ><i><b>f</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-alagappan2005_4-6"
                            ><sup
                              ><i><b>g</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-alagappan2005_4-7"
                            ><sup
                              ><i><b>h</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-alagappan2005_4-8"
                            ><sup
                              ><i><b>i</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-alagappan2005_4-9"
                            ><sup
                              ><i><b>j</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-alagappan2005_4-10"
                            ><sup
                              ><i><b>k</b></i></sup
                            ></a
                          ></span
                        >
                        <span class="reference-text"
                          ><link
                            rel="mw-deduplicated-inline-style"
                            href="mw-data:TemplateStyles:r1238218222" /><cite
                            id="CITEREFAlagappanHolliman2005"
                            class="citation journal cs1"
                            >Alagappan, Kumar; Holliman, C. James (2005).
                            "History of the Development of International
                            Emergency Medicine".
                            <i>Emergency Medicine Clinics of North America</i>.
                            <b>23</b> (1): <span class="nowrap">1–</span>10.
                            <a
                              href="/wiki/Doi_(identifier)"
                              class="mw-redirect"
                              title="Doi (identifier)"
                              >doi</a
                            >:<a
                              rel="nofollow"
                              class="external text"
                              href="https://doi.org/10.1016%2Fj.emc.2004.09.013"
                              >10.1016/j.emc.2004.09.013</a
                            >.
                            <a
                              href="/wiki/PMID_(identifier)"
                              class="mw-redirect"
                              title="PMID (identifier)"
                              >PMID</a
                            >&nbsp;<a
                              rel="nofollow"
                              class="external text"
                              href="https://pubmed.ncbi.nlm.nih.gov/15663970"
                              >15663970</a
                            >.</cite
                          ><span
                            title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Emergency+Medicine+Clinics+of+North+America&amp;rft.atitle=History+of+the+Development+of+International+Emergency+Medicine&amp;rft.volume=23&amp;rft.issue=1&amp;rft.pages=1-10&amp;rft.date=2005&amp;rft_id=info%3Adoi%2F10.1016%2Fj.emc.2004.09.013&amp;rft_id=info%3Apmid%2F15663970&amp;rft.aulast=Alagappan&amp;rft.aufirst=Kumar&amp;rft.au=Holliman%2C+C.+James&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AInternational+emergency+medicine"
                            class="Z3988"
                          ></span
                        ></span>
                      </li>
                      <li id="cite_note-Pozner-5">
                        <span class="mw-cite-backlink"
                          ><b><a href="#cite_ref-Pozner_5-0">^</a></b></span
                        >
                        <span class="reference-text"
                          ><link
                            rel="mw-deduplicated-inline-style"
                            href="mw-data:TemplateStyles:r1238218222" /><cite
                            id="CITEREFPoznerZaneNelsonLevine2004"
                            class="citation journal cs1"
                            >Pozner, Charles N; Zane, Richard; Nelson, Stephen
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                            <a
                              href="/wiki/Doi_(identifier)"
                              class="mw-redirect"
                              title="Doi (identifier)"
                              >doi</a
                            >:<a
                              rel="nofollow"
                              class="external text"
                              href="https://doi.org/10.1016%2Fj.resuscitation.2003.11.004"
                              >10.1016/j.resuscitation.2003.11.004</a
                            >.
                            <a
                              href="/wiki/PMID_(identifier)"
                              class="mw-redirect"
                              title="PMID (identifier)"
                              >PMID</a
                            >&nbsp;<a
                              rel="nofollow"
                              class="external text"
                              href="https://pubmed.ncbi.nlm.nih.gov/15050754"
                              >15050754</a
                            >.</cite
                          ><span
                            title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Resuscitation&amp;rft.atitle=International+EMS+Systems%3A+The+United+States%3A+Past%2C+Present%2C+and+Future&amp;rft.volume=60&amp;rft.issue=3&amp;rft.pages=239-44&amp;rft.date=2004-03&amp;rft_id=info%3Adoi%2F10.1016%2Fj.resuscitation.2003.11.004&amp;rft_id=info%3Apmid%2F15050754&amp;rft.aulast=Pozner&amp;rft.aufirst=Charles+N&amp;rft.au=Zane%2C+Richard&amp;rft.au=Nelson%2C+Stephen+J&amp;rft.au=Levine%2C+Michael&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AInternational+emergency+medicine"
                            class="Z3988"
                          ></span
                        ></span>
                      </li>
                      <li id="cite_note-Odero-6">
                        <span class="mw-cite-backlink"
                          >^
                          <a href="#cite_ref-Odero_6-0"
                            ><sup
                              ><i><b>a</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Odero_6-1"
                            ><sup
                              ><i><b>b</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Odero_6-2"
                            ><sup
                              ><i><b>c</b></i></sup
                            ></a
                          ></span
                        >
                        <span class="reference-text"
                          ><link
                            rel="mw-deduplicated-inline-style"
                            href="mw-data:TemplateStyles:r1238218222" /><cite
                            id="CITEREFOderoGarnerZwi1997"
                            class="citation journal cs1"
                            >Odero, W.; Garner, P.; Zwi, A. (1997).
                            <a
                              rel="nofollow"
                              class="external text"
                              href="https://doi.org/10.1111%2Fj.1365-3156.1997.tb00167.x"
                              >"Road Traffic Injuries in Developing Countries: a
                              Comprehensive Review of Epidemiological
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                            >.
                            <i>Tropical Medicine &amp; International Health</i>.
                            <b>2</b> (5): <span class="nowrap">445–</span>60.
                            <a
                              href="/wiki/Doi_(identifier)"
                              class="mw-redirect"
                              title="Doi (identifier)"
                              >doi</a
                            >:<span
                              class="id-lock-free"
                              title="Freely accessible"
                              ><a
                                rel="nofollow"
                                class="external text"
                                href="https://doi.org/10.1111%2Fj.1365-3156.1997.tb00167.x"
                                >10.1111/j.1365-3156.1997.tb00167.x</a
                              ></span
                            >.
                            <a
                              href="/wiki/PMID_(identifier)"
                              class="mw-redirect"
                              title="PMID (identifier)"
                              >PMID</a
                            >&nbsp;<a
                              rel="nofollow"
                              class="external text"
                              href="https://pubmed.ncbi.nlm.nih.gov/9217700"
                              >9217700</a
                            >.</cite
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                            title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Tropical+Medicine+%26+International+Health&amp;rft.atitle=Road+Traffic+Injuries+in+Developing+Countries%3A+a+Comprehensive+Review+of+Epidemiological+Studies&amp;rft.volume=2&amp;rft.issue=5&amp;rft.pages=445-60&amp;rft.date=1997&amp;rft_id=info%3Adoi%2F10.1111%2Fj.1365-3156.1997.tb00167.x&amp;rft_id=info%3Apmid%2F9217700&amp;rft.aulast=Odero&amp;rft.aufirst=W.&amp;rft.au=Garner%2C+P.&amp;rft.au=Zwi%2C+A.&amp;rft_id=https%3A%2F%2Fdoi.org%2F10.1111%252Fj.1365-3156.1997.tb00167.x&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AInternational+emergency+medicine"
                            class="Z3988"
                          ></span
                        ></span>
                      </li>
                      <li id="cite_note-Razzak-7">
                        <span class="mw-cite-backlink"
                          >^
                          <a href="#cite_ref-Razzak_7-0"
                            ><sup
                              ><i><b>a</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Razzak_7-1"
                            ><sup
                              ><i><b>b</b></i></sup
                            ></a
                          ></span
                        >
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                            rel="mw-deduplicated-inline-style"
                            href="mw-data:TemplateStyles:r1238218222" /><cite
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                            class="citation journal cs1"
                            >Razzak, Junaid A.; Kellermann, Arthur L. (November
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                              rel="nofollow"
                              class="external text"
                              href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2567674"
                              >"Emergency Medical Care in Developing Countries:
                              Is It Worthwhile?"</a
                            >. <i>Bulletin of the World Health Organization</i>.
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                            <a
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                              title="Hdl (identifier)"
                              >hdl</a
                            >:<a
                              rel="nofollow"
                              class="external text"
                              href="https://hdl.handle.net/10665%2F71519"
                              >10665/71519</a
                            >.
                            <a
                              href="/wiki/PMC_(identifier)"
                              class="mw-redirect"
                              title="PMC (identifier)"
                              >PMC</a
                            >&nbsp;<span
                              class="id-lock-free"
                              title="Freely accessible"
                              ><a
                                rel="nofollow"
                                class="external text"
                                href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2567674"
                                >2567674</a
                              ></span
                            >.
                            <a
                              href="/wiki/PMID_(identifier)"
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                              title="PMID (identifier)"
                              >PMID</a
                            >&nbsp;<a
                              rel="nofollow"
                              class="external text"
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                              >12481213</a
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                            class="Z3988"
                          ></span
                        ></span>
                      </li>
                      <li id="cite_note-Jochberger-8">
                        <span class="mw-cite-backlink"
                          >^
                          <a href="#cite_ref-Jochberger_8-0"
                            ><sup
                              ><i><b>a</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Jochberger_8-1"
                            ><sup
                              ><i><b>b</b></i></sup
                            ></a
                          ></span
                        >
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                            rel="mw-deduplicated-inline-style"
                            href="mw-data:TemplateStyles:r1238218222" /><cite
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                              class="external text"
                              href="https://doi.org/10.1213%2Fane.0b013e318166ecb8"
                              >"Anesthesia and Its Allied Disciplines in the
                              Developing World: A Nationwide Survey of the
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                            <a
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                              title="Doi (identifier)"
                              >doi</a
                            >:<span
                              class="id-lock-free"
                              title="Freely accessible"
                              ><a
                                rel="nofollow"
                                class="external text"
                                href="https://doi.org/10.1213%2Fane.0b013e318166ecb8"
                                >10.1213/ane.0b013e318166ecb8</a
                              ></span
                            >.
                            <a
                              href="/wiki/PMID_(identifier)"
                              class="mw-redirect"
                              title="PMID (identifier)"
                              >PMID</a
                            >&nbsp;<a
                              rel="nofollow"
                              class="external text"
                              href="https://pubmed.ncbi.nlm.nih.gov/18292444"
                              >18292444</a
                            >.
                            <a
                              href="/wiki/S2CID_(identifier)"
                              class="mw-redirect"
                              title="S2CID (identifier)"
                              >S2CID</a
                            >&nbsp;<a
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                              >28740274</a
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                            class="Z3988"
                          ></span
                        ></span>
                      </li>
                      <li id="cite_note-9">
                        <span class="mw-cite-backlink"
                          ><b><a href="#cite_ref-9">^</a></b></span
                        >
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                              >"The Globalization of Emergency Medicine and Its
                              Importance for Public Health"</a
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                              >doi</a
                            >:<a
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                              class="external text"
                              href="https://doi.org/10.2471%2Fblt.05.028548"
                              >10.2471/blt.05.028548</a
                            >.
                            <a
                              href="/wiki/PMC_(identifier)"
                              class="mw-redirect"
                              title="PMC (identifier)"
                              >PMC</a
                            >&nbsp;<span
                              class="id-lock-free"
                              title="Freely accessible"
                              ><a
                                rel="nofollow"
                                class="external text"
                                href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2627492"
                                >2627492</a
                              ></span
                            >.
                            <a
                              href="/wiki/PMID_(identifier)"
                              class="mw-redirect"
                              title="PMID (identifier)"
                              >PMID</a
                            >&nbsp;<a
                              rel="nofollow"
                              class="external text"
                              href="https://pubmed.ncbi.nlm.nih.gov/17128364"
                              >17128364</a
                            >.</cite
                          ><span
                            title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Bulletin+of+the+World+Health+Organization&amp;rft.atitle=The+Globalization+of+Emergency+Medicine+and+Its+Importance+for+Public+Health&amp;rft.volume=84&amp;rft.issue=10&amp;rft.pages=835-9&amp;rft.date=2006-10&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2627492%23id-name%3DPMC&amp;rft_id=info%3Apmid%2F17128364&amp;rft_id=info%3Adoi%2F10.2471%2Fblt.05.028548&amp;rft.aulast=Anderson&amp;rft.aufirst=Philip&amp;rft.au=Petrino%2C+Roberta&amp;rft.au=Halpern%2C+Pinchas&amp;rft.au=Tintinalli%2C+Judith&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2627492&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AInternational+emergency+medicine"
                            class="Z3988"
                          ></span
                        ></span>
                      </li>
                      <li id="cite_note-Holliman-10">
                        <span class="mw-cite-backlink"
                          >^
                          <a href="#cite_ref-Holliman_10-0"
                            ><sup
                              ><i><b>a</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Holliman_10-1"
                            ><sup
                              ><i><b>b</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Holliman_10-2"
                            ><sup
                              ><i><b>c</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Holliman_10-3"
                            ><sup
                              ><i><b>d</b></i></sup
                            ></a
                          ></span
                        >
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                            rel="mw-deduplicated-inline-style"
                            href="mw-data:TemplateStyles:r1238218222" /><cite
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                              title="Doi (identifier)"
                              >doi</a
                            >:<a
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                              class="external text"
                              href="https://doi.org/10.1016%2Fj.emc.2004.10.001"
                              >10.1016/j.emc.2004.10.001</a
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                            <a
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                              title="PMID (identifier)"
                              >PMID</a
                            >&nbsp;<a
                              rel="nofollow"
                              class="external text"
                              href="https://pubmed.ncbi.nlm.nih.gov/15663978"
                              >15663978</a
                            >.</cite
                          ><span
                            title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Emergency+Medicine+Clinics+of+North+America&amp;rft.atitle=Lessons+Learned+from+International+Emergency+Medicine+Development&amp;rft.volume=23&amp;rft.issue=1&amp;rft.pages=133-47&amp;rft.date=2005-02&amp;rft_id=info%3Adoi%2F10.1016%2Fj.emc.2004.10.001&amp;rft_id=info%3Apmid%2F15663978&amp;rft.aulast=Arnold&amp;rft.aufirst=Jeffrey+L.&amp;rft.au=Holliman%2C+C.+James&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AInternational+emergency+medicine"
                            class="Z3988"
                          ></span
                        ></span>
                      </li>
                      <li id="cite_note-11">
                        <span class="mw-cite-backlink"
                          ><b><a href="#cite_ref-11">^</a></b></span
                        >
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                            rel="mw-deduplicated-inline-style"
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                              >doi</a
                            >:<a
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                              >10.1016/s0735-6757(97)90167-4</a
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                            class="Z3988"
                          ></span
                        ></span>
                      </li>
                      <li id="cite_note-12">
                        <span class="mw-cite-backlink"
                          ><b><a href="#cite_ref-12">^</a></b></span
                        >
                        <span class="reference-text"
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                            rel="mw-deduplicated-inline-style"
                            href="mw-data:TemplateStyles:r1238218222" /><cite
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                              >doi</a
                            >:<a
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                          >
                          <a href="#cite_ref-Slinger_17-1"
                            ><sup
                              ><i><b>b</b></i></sup
                            ></a
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                        <span class="mw-cite-backlink"
                          >^
                          <a href="#cite_ref-holliman_21-0"
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                              ><i><b>a</b></i></sup
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                          <a href="#cite_ref-holliman_21-1"
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                              ><i><b>b</b></i></sup
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                              href="http://www.ifem.cc/About_IFEM.aspx"
                              >the original</a
                            >
                            on 20 September 2013<span
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                            href="mw-data:TemplateStyles:r1238218222" /><cite
                            class="citation web cs1"
                            ><a
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                              class="external text"
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                              >"International Conference on Emergency
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                              >the original</a
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                            class="Z3988"
                          ></span
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                      <li id="cite_note-Caruso-23">
                        <span class="mw-cite-backlink"
                          >^
                          <a href="#cite_ref-Caruso_23-0"
                            ><sup
                              ><i><b>a</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Caruso_23-1"
                            ><sup
                              ><i><b>b</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Caruso_23-2"
                            ><sup
                              ><i><b>c</b></i></sup
                            ></a
                          ></span
                        >
                        <span class="reference-text"
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                              >"Development of Emergency Medicine in
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                            <a
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                              title="Doi (identifier)"
                              >doi</a
                            >:<span
                              class="id-lock-free"
                              title="Freely accessible"
                              ><a
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                                class="external text"
                                href="https://doi.org/10.1016%2Fj.afjem.2011.08.002"
                                >10.1016/j.afjem.2011.08.002</a
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                        <span class="mw-cite-backlink"
                          ><b><a href="#cite_ref-24">^</a></b></span
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                            <a
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                              >19703741</a
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                          >^
                          <a href="#cite_ref-Waseem_25-0"
                            ><sup
                              ><i><b>a</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Waseem_25-1"
                            ><sup
                              ><i><b>b</b></i></sup
                            ></a
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                              >"Establishing a Successful Pre-hospital Emergency
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                            class="Z3988"
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                      <li id="cite_note-Aschekenasy-26">
                        <span class="mw-cite-backlink"
                          >^
                          <a href="#cite_ref-Aschekenasy_26-0"
                            ><sup
                              ><i><b>a</b></i></sup
                            ></a
                          >
                          <a href="#cite_ref-Aschekenasy_26-1"
                            ><sup
                              ><i><b>b</b></i></sup
                            ></a
                          ></span
                        >
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                            href="mw-data:TemplateStyles:r1238218222" /><cite
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                              >"International Emergency Medicine: A Review of
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                            <a
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                        <span class="mw-cite-backlink"
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                                href="https://doi.org/10.1007%2Fs00268-014-2805-7"
                                >10.1007/s00268-014-2805-7</a
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                            <a
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                              >25277980</a
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                            <a
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                        <tr>
                          <th scope="col" class="navbox-title" colspan="2">
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                                  <a
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                                      >v</abbr
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                                  >
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                              <a
                                href="/wiki/Emergency_medicine"
                                title="Emergency medicine"
                                >Emergency medicine</a
                              >
                            </div>
                          </th>
                        </tr>
                        <tr>
                          <th
                            scope="row"
                            class="navbox-group"
                            style="width: 1%"
                          >
                            Emergency medicine
                          </th>
                          <td
                            class="navbox-list-with-group navbox-list navbox-odd"
                            style="width: 100%; padding: 0"
                          >
                            <div style="padding: 0 0.25em">
                              <ul>
                                <li>
                                  <a
                                    href="/wiki/Emergency_department"
                                    title="Emergency department"
                                    >Emergency department</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Emergency_medical_services"
                                    title="Emergency medical services"
                                    >Emergency medical services</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Emergency_nursing"
                                    title="Emergency nursing"
                                    >Emergency nursing</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Emergency_psychiatry"
                                    title="Emergency psychiatry"
                                    >Emergency psychiatry</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Golden_hour_(medicine)"
                                    title="Golden hour (medicine)"
                                    >Golden hour</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Medical_emergency"
                                    title="Medical emergency"
                                    >Medical emergency</a
                                  >
                                </li>
                                <li>
                                  <a class="mw-selflink selflink"
                                    >International emergency medicine</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Pediatric_emergency_medicine"
                                    title="Pediatric emergency medicine"
                                    >Pediatric emergency medicine</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Pre-hospital_emergency_medicine"
                                    title="Pre-hospital emergency medicine"
                                    >Pre-hospital emergency medicine</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Major_trauma"
                                    title="Major trauma"
                                    >Major trauma</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Trauma_center"
                                    title="Trauma center"
                                    >Trauma center</a
                                  >
                                </li>
                                <li>
                                  <a href="/wiki/Triage" title="Triage"
                                    >Triage</a
                                  >
                                </li>
                              </ul>
                            </div>
                          </td>
                        </tr>
                        <tr>
                          <th
                            scope="row"
                            class="navbox-group"
                            style="width: 1%"
                          >
                            <a
                              href="/wiki/Category:Emergency_medical_equipment"
                              title="Category:Emergency medical equipment"
                              >Equipment</a
                            >
                          </th>
                          <td
                            class="navbox-list-with-group navbox-list navbox-even"
                            style="width: 100%; padding: 0"
                          >
                            <div style="padding: 0 0.25em">
                              <ul>
                                <li>
                                  <a
                                    href="/wiki/Bag_valve_mask"
                                    title="Bag valve mask"
                                    >Bag valve mask</a
                                  >
                                  (BVM)
                                </li>
                                <li>
                                  <a href="/wiki/Chest_tube" title="Chest tube"
                                    >Chest tube</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Defibrillation"
                                    title="Defibrillation"
                                    >Defibrillation</a
                                  >
                                  (<a
                                    href="/wiki/Automated_external_defibrillator"
                                    title="Automated external defibrillator"
                                    >AED</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Implantable_cardioverter-defibrillator"
                                    title="Implantable cardioverter-defibrillator"
                                    >ICD</a
                                  >)
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Electrocardiography"
                                    title="Electrocardiography"
                                    >Electrocardiogram</a
                                  >
                                  (ECG/EKG)
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Intraosseous_infusion"
                                    title="Intraosseous infusion"
                                    >Intraosseous infusion</a
                                  >
                                  (IO)
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Intravenous_therapy"
                                    title="Intravenous therapy"
                                    >Intravenous therapy</a
                                  >
                                  (IV)
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Tracheal_intubation"
                                    title="Tracheal intubation"
                                    >Tracheal intubation</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Laryngeal_tube"
                                    title="Laryngeal tube"
                                    >Laryngeal tube</a
                                  >
                                </li>
                                <li>
                                  <a href="/wiki/Combitube" title="Combitube"
                                    >Combitube</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Nasopharyngeal_airway"
                                    title="Nasopharyngeal airway"
                                    >Nasopharyngeal airway</a
                                  >
                                  (NPA)
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Oropharyngeal_airway"
                                    title="Oropharyngeal airway"
                                    >Oropharyngeal airway</a
                                  >
                                  (OPA)
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Pocket_mask"
                                    title="Pocket mask"
                                    >Pocket mask</a
                                  >
                                </li>
                              </ul>
                            </div>
                          </td>
                        </tr>
                        <tr>
                          <th
                            scope="row"
                            class="navbox-group"
                            style="width: 1%"
                          >
                            Drugs
                          </th>
                          <td
                            class="navbox-list-with-group navbox-list navbox-odd"
                            style="width: 100%; padding: 0"
                          >
                            <div style="padding: 0 0.25em">
                              <ul>
                                <li>
                                  <a href="/wiki/Adenosine" title="Adenosine"
                                    >Adenosine</a
                                  >
                                </li>
                                <li>
                                  <a href="/wiki/Amiodarone" title="Amiodarone"
                                    >Amiodarone</a
                                  >
                                </li>
                                <li>
                                  <a href="/wiki/Atropine" title="Atropine"
                                    >Atropine</a
                                  >
                                </li>
                                <li>
                                  <a href="/wiki/Dopamine" title="Dopamine"
                                    >Dopamine</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Epinephrine"
                                    class="mw-redirect"
                                    title="Epinephrine"
                                    >Epinephrine / Adrenaline</a
                                  >
                                </li>
                                <li>
                                  <a href="/wiki/Naloxone" title="Naloxone"
                                    >Naloxone</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Magnesium_sulfate"
                                    title="Magnesium sulfate"
                                    >Magnesium sulfate</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Sodium_bicarbonate"
                                    title="Sodium bicarbonate"
                                    >Sodium bicarbonate</a
                                  >
                                </li>
                              </ul>
                            </div>
                          </td>
                        </tr>
                        <tr>
                          <th
                            scope="row"
                            class="navbox-group"
                            style="width: 1%"
                          >
                            <a
                              href="/wiki/Category:Emergency_medicine_organisations"
                              title="Category:Emergency medicine organisations"
                              >Organisations</a
                            >
                          </th>
                          <td
                            class="navbox-list-with-group navbox-list navbox-even"
                            style="width: 100%; padding: 0"
                          >
                            <div style="padding: 0 0.25em">
                              <ul>
                                <li>
                                  <a
                                    href="/wiki/International_Federation_for_Emergency_Medicine"
                                    title="International Federation for Emergency Medicine"
                                    >International Federation for Emergency
                                    Medicine</a
                                  >
                                  (<a
                                    href="/wiki/International_Conference_on_Emergency_Medicine"
                                    title="International Conference on Emergency Medicine"
                                    >International Conference on Emergency
                                    Medicine</a
                                  >)
                                </li>
                                <li>
                                  <a
                                    href="/wiki/American_College_of_Emergency_Physicians"
                                    title="American College of Emergency Physicians"
                                    >American College of Emergency Physicians</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Australasian_College_for_Emergency_Medicine"
                                    title="Australasian College for Emergency Medicine"
                                    >Australasian College for Emergency
                                    Medicine</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Canadian_Association_of_Emergency_Physicians"
                                    title="Canadian Association of Emergency Physicians"
                                    >Canadian Association of Emergency
                                    Physicians</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Royal_College_of_Emergency_Medicine"
                                    title="Royal College of Emergency Medicine"
                                    >Royal College of Emergency Medicine</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/European_Society_for_Emergency_Medicine"
                                    title="European Society for Emergency Medicine"
                                    >European Society for Emergency Medicine</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Asian_Society_for_Emergency_Medicine"
                                    class="mw-redirect"
                                    title="Asian Society for Emergency Medicine"
                                    >Asian Society for Emergency Medicine</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/American_Academy_of_Emergency_Medicine"
                                    title="American Academy of Emergency Medicine"
                                    >American Academy of Emergency Medicine</a
                                  >
                                </li>
                              </ul>
                            </div>
                          </td>
                        </tr>
                        <tr>
                          <th
                            scope="row"
                            class="navbox-group"
                            style="width: 1%"
                          >
                            <a
                              href="/wiki/Category:Emergency_medicine_courses"
                              title="Category:Emergency medicine courses"
                              >Courses</a
                            >
                            /
                            <a
                              href="/wiki/Category:Emergency_life_support"
                              title="Category:Emergency life support"
                              >Life support</a
                            >
                          </th>
                          <td
                            class="navbox-list-with-group navbox-list navbox-odd"
                            style="width: 100%; padding: 0"
                          >
                            <div style="padding: 0 0.25em">
                              <ul>
                                <li>
                                  <a href="/wiki/First_aid" title="First aid"
                                    >First aid</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Cardiopulmonary_resuscitation"
                                    title="Cardiopulmonary resuscitation"
                                    >Cardiopulmonary resuscitation</a
                                  >
                                  (CPR)
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Mouth-to-mouth_resuscitation"
                                    title="Mouth-to-mouth resuscitation"
                                    >Mouth-to-mouth resuscitation</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Basic_life_support"
                                    title="Basic life support"
                                    >Basic life support</a
                                  >
                                  (BLS)
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Advanced_cardiac_life_support"
                                    title="Advanced cardiac life support"
                                    >Advanced cardiac life support</a
                                  >
                                  (ACLS)
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Advanced_trauma_life_support"
                                    title="Advanced trauma life support"
                                    >Advanced trauma life support</a
                                  >
                                  (ATLS)
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Neonatal_Resuscitation_Program"
                                    title="Neonatal Resuscitation Program"
                                    >Neonatal Resuscitation Program</a
                                  >
                                  (NRP)
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Acute_Care_of_at-Risk_Newborns"
                                    title="Acute Care of at-Risk Newborns"
                                    >Acute Care of at-Risk Newborns</a
                                  >
                                  (ACoRN)
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Pediatric_basic_life_support"
                                    title="Pediatric basic life support"
                                    >Pediatric basic life support</a
                                  >
                                  (PBLS)
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Pediatric_Advanced_Life_Support"
                                    class="mw-redirect"
                                    title="Pediatric Advanced Life Support"
                                    >Pediatric Advanced Life Support</a
                                  >
                                  (PALS)
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Advanced_Life_Support_in_Obstetrics"
                                    title="Advanced Life Support in Obstetrics"
                                    >Advanced Life Support in Obstetrics</a
                                  >
                                  (ALSO)
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Care_of_the_Critically_Ill_Surgical_Patient"
                                    title="Care of the Critically Ill Surgical Patient"
                                    >Care of the Critically Ill Surgical
                                    Patient</a
                                  >
                                  (CCrISP)
                                </li>
                              </ul>
                            </div>
                          </td>
                        </tr>
                        <tr>
                          <th
                            scope="row"
                            class="navbox-group"
                            style="width: 1%"
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                            Scoring systems
                          </th>
                          <td
                            class="navbox-list-with-group navbox-list navbox-even"
                            style="width: 100%; padding: 0"
                          >
                            <div style="padding: 0 0.25em">
                              <ul>
                                <li>
                                  <a href="/wiki/NACA_score" title="NACA score"
                                    >NACA score</a
                                  >
                                </li>
                                <li>
                                  <a
                                    href="/wiki/Injury_Severity_Score"
                                    title="Injury Severity Score"
                                    >Injury Severity Score</a
                                  >
                                </li>
                              </ul>
                            </div>
                          </td>
                        </tr>
                        <tr>
                          <td class="navbox-abovebelow" colspan="2">
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                                    ><span class="noviewer" typeof="mw:File"
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                                    <a
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                                </li>
                                <li>
                                  <b
                                    ><span class="noviewer" typeof="mw:File"
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                                    <a
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